Letters to the Editor

Abstract

Anne Moore (“Her First Pelvic Exam: Helpful Hints for the Practitioner,” September 2007) provided helpful hints for the practitioner to perform pelvic examination (PV). Direct eye contact is an essential element during patient-doctor communication in Western culture. In Taiwan, traditionally, we set up a screen just above the abdomen of a lithotomy-positioned woman prepared for a PV, to avoid direct eye contact. For understanding the real desire of Taiwanese women during PV, I recently performed a pilot study for 3 months. During the 3-month period, only 10 of the 514 PV cases asked for direct eye contact with the doctor. Even after explanation of the benefits of direct eye contact, 309 patients still refused direct eye contact during PV. From the viewpoint of holistic care, I suggest that, in performing a physical examination, especially on a sensitive part of the body, we should take cultural differences into consideration. Thank you for your insightful commentary. Certainly understanding cultural influences is imperative in providing sensitive, appropriate care. I have found, as well, that a number of patients prefer NOT to know the details of the speculum and bimanual exam. What is most important is that we query patients regarding their personal preferences and concerns. Thank you again!